Baby and child allergies: May'13

29 May 2013

Kamilla Dougherty our Health at Hand nurse answered your questions on baby and child allergies including symptoms, diagnosis and treatments.

Missing Sleep asked: My son is asthmatic, so I would like to know the best way to manage this whilst still encouraging him to be active.  Outside there can be quite a few triggers for him with all the pollen, so I want to do what I can to keep him well. Thank you :)

Kamilla Dougherty our Health at Hand nurse answered: Hello Missing Sleep.The best way to manage asthma in children is to try to avoid triggers. Many things can make asthma worse. Keep a list of your sons triggers when you discover them, and discuss them with your GP or asthma nurse.It is important to keep children active and encourage outdoor play. Change his clothes immediately after outdoor play and keep his bedroom window closed at peak pollen time.

Mirka Moore asked: I would like to know if my two daughters have a bigger chance to have asthma because their dad suffers with this condition?

Kamilla Dougherty our Health at Hand nurse answered: The causes of asthma are not always clear. In children, asthma is more common in boys than in girls but in adults, women are more likely to have asthma. Asthma may run in families.

mumofthemig asked: Is it is possible for a child to develop an allergy to bee and wasp stings or is it something they will be born with which you won't know about until they get their first sting.

Kamilla Dougherty our Health at Hand nurse answered: The history of a child’s reactions to insect stings is useful in assessing whether they are allergic. Skin prick tests and blood tests are not 100% reliable for insect sting allergy, so sometimes it can be necessary to perform a special skin test (called an intradermal injection) to determine true allergy. Testing is advisable after the child’s first contact with a bee or wasp.

The Mini Mes and Me asked: What natural products can you use to help reduce/prevent hayfever?

Kamilla Dougherty our Health at Hand nurse answered: While there isn't much evidence about how well they work, a number of people try alternative treatments for hay fever. These include: Herbal remedies and supplements. Extracts of the shrub butterbur may help prevent seasonal allergy symptoms. There's some limited evidence that spirulina and Tinospora cordifolia also may be effective. Though their benefits are unclear, other herbal remedies for seasonal allergies include capsicum, honey, vitamin C and fish oil.

Alternative therapies. Some people claim that therapies such as acupuncture and homeopathy may help with seasonal allergy symptoms. However, there's no clear evidence showing that these treatments work.

LauraCYMFT asked: What tips can you give us hayfever sufferers?

Kamilla Dougherty our Health at Hand nurse answered: Allergen avoidance is difficult for people with allergy to substances in the air, such as pollen. For example, tiny pollen spores are windborne and travel for miles on air currents. You could:

  • Monitor pollen forecasts daily and stay indoors wherever possible when the count is high
  • Limit outdoor trips to rural areas. If you go out, shower and wash your hair on return
  • Keep windows closed when indoors and overnight whilst you are sleeping.
  • Wear wraparound sunglasses when outdoors to keep allergens out of your eyes.
  • Apply an effective pollen barrier around the edge of each nostril to trap or block pollens.

Ruth asked: How can you tell between an allergy and an intolerance?

Kamilla Dougherty our Health at Hand nurse answered: Hi Ruth, a food intolerance can cause some of the same signs and symptoms as a food allergy but a true food allergy causes an immune system reaction that affects numerous organs in the body. It can cause a range of symptoms. In some cases, an allergic food reaction can be severe or life-threatening. In contrast, food intolerance symptoms are generally less serious and are limited to digestive problems.

Anonymous2 asked: What is the best rememdy to releive the symptoms of hayfever in babies?

Kamilla Dougherty our Health at Hand nurse answered: Hello Anonymous2. Hayfever symptoms in babies needs to be diagnosed by your doctor. Normally the symptoms can be controlled by using antihistamine liquids which fall into two catogories sedating and no sedating. Piriton liquid which contains Chlorphenamine can be given to children over 1 year old and can be used in babies. However, because it causes drowsiness it is not ideal. Benadryl Allergy Children’s Solution is non sedating so will not cause drowsiness but can only be given to children over 2 years old. Both Piriton Liquid and Benadryl Allergy Children’s solution can be purchased in a pharmacy. For very young babies under 6 months Normal Saline drops can be used for a blocked or runny nose. Sterimar Baby can also be used to clear nasal passages for babies from birth to 3 years.



fiona asked: Are there any issues with babies having sensitive skin and using spf?

Kamilla Dougherty our Health at Hand nurse answered: Hi Fiona, It is difficult to say specifically if a child with sensitive skin is going to be allergic to a cream containing Sun Protection Factor (SPF). They can be allergic to a component or excipients within the cream. People and babies in particular do need to use sun protective creams with a high SPF factor to block the harmful UVA and UVB rays but there are many products available on the market for sensitive skins and high SPF. It is a matter of trying them.
Performing a patch test gives a useful indication if your child is allergic to a particular product. This is done by apply a small amount of cream on an area such as the back of an arm, leaving it on for a short period say about 12 hours . If that area is inflamed after 12-24 hours then do not use it. If it is not raised then you may want to try it on a larger area.

Heather asked: My concern would be for a child developing a serious allergy such a nut allergy - can you get a general check for child allergies at your GP prior to them eating something that might be potentially dangerous for them?

Kamilla Dougherty our Health at Hand nurse answered: Hello Heather. We cannot yet give all the answers we would like to give to parents in response to questions about why and how allergy develops.It would be difficult to test a child for an allergy prior to exposure. Please speak to your GP if you have specific problems or family history with food allergies.

Nick asked: How common is hayfever in babies and are they prone to suffering more from particular types of pollen?

Kamilla Dougherty our Health at Hand nurse answered: Hello Nick. Hay fever doesn't usually affect children until they're about seven, and older children and teenagers are more susceptible to the allergy than adults.

LauraCYMFT asked: What can trigger outbreak in eczema outdoors?

Kamilla Dougherty our Health at Hand nurse answered: Hello Laura, Letting children run and play outside with their friends is important for their physical and emotional development. This development is vital even for the child with eczema.  Taking a few extra precautions will help minimise the risk of a flare up whilst your child is outside doing what children do best – having fun. Minimising prolonged exposure to sun, heat, restricting play to paved areas away from allergy filled garden beds and lawns will reduce allergies and eczema flare ups.  If children are to sit on the lawn place a blanket out for them to sit on so the grass will not irritate their skin.

LauraCYMFT commented: What about suncream? Obviously I use it, but is there a particular kind that can help to not irritate eczema?

Anonymous72 asked: How can my child’s food allergies impact their health in other ways?

Kamilla Dougherty our Health at Hand nurse answered: Hello Anonymous. Many children grow out of food allergies, such as cow’s milk, eggs and wheat allergies, as they get older. Around two in 10 children outgrow an allergy to peanuts.Most food allergy reactions are mild, though they can be uncomfortable and distressing. There should be no negative impact on your child's health other then missing out on certain foods and understanding the allergy triggers.

Chaz asked: When can baby have Benadryl?

Kamilla Dougherty our Health at Hand nurse answered: Hello Chaz, Benadryl Allergy Children's ( banana flavoured) Solution can be given to children 2-5 years.

fiona asked: Can cradle cap be linked to allergies?

Kamilla Dougherty our Health at Hand nurse answered: Hello Fiona, it is not clear what the causes of cradle cap are, however it has been confirmed that the causes are neither allergy, bacterial infection nor bad hygiene.There is a theory that the overactive sebaceous glands produce too much sebum, which in turn prevents the old skin cells from drying and falling off the scalp (instead they stick to the scalp). The reason the glands are overactive is because sometimes the mother's hormones can remain in the baby's body for a number of months after birth

fiona commented: Thanks, very interesting

fiona commented: Good to know it's not an allergy

MK asked: How can I prevent my baby from getting allergies?

Kamilla Dougherty our Health at Hand nurse answered: Hello MK. There is no clear way to say what to do to prevent your child from getting an allergy. Family history of allergy and asthma can be used to identify children at increased risk so as a parent you should be informed and be vigilant to be able to spot a possible allergy trigger. A good basic hygene and well balanced diet will minimise the risk.

Heather asked: Are their ways you can improve your childs immunity to allergies whilst your pregnant?

Kamilla Dougherty our Health at Hand nurse answered: Hi Heather, during pregnancy to improve your child's immunity to allergies the best advice is to eat healthily including fresh fruits and vegetables and to avoid smoking.

Anonymous85 asked: Should we have our children tested regularly for allergies?

Kamilla Dougherty our Health at Hand nurse answered: Hello Anonymous85, Allergy testing can be painful and  distressing for children. If your children are not showing any allergy symptoms there is no need for annual allergy testing.

Ruth asked: Are allergies becoming more common or has medicine just become better in identifying them? It seems like everyone's got one these days.

Kamilla Dougherty our Health at Hand nurse answered: Hi Ruth, Researchers  believe that the environment plays a key role in the likelihood of developing an allergy.The thinking behind this, and much of the research into allergies, is that modern hygiene habits and the developed world’s fixation with destroying germs mean that many of our children may not be developing adequate immune systems. 50% of children in the UK now have some form of allergic condition.To answer your question, allergies are becoming more common.

Anonymous86 asked: my son has chronic allergic rhinitis/sinusitis and asthma (usually triggered by viruses/chest infections). Can he be tested to see what is loikely to be triggering his problems. We have a cat.

Kamilla Dougherty our Health at Hand nurse answered: Hi Anonymous86. The best allergy test (known as a ‘gold standard’ test) is to expose a person to the allergen concerned, such as a food or cat known as an Allergy Challenge test. Since this may cause an allergic reaction, such a test should generally only take place in a specialist clinic where appropriate medical facilities are available to manage any reaction.

gemma asked: Hi my daughter is 32 months old and we think she suffers with hayfever. Whenever she is outside she comes in coughin and rubs eyes. Dr gave us loratidine syrup. We are worried about usin it after readin it can make her heart race? Also piriton makes her drowsy. Can kids get hayfever this young? What alternative remedies are there? Thanks

Kamilla Dougherty our Health at Hand nurse answered: Allergies can develop at any age including hayfever. It is best to have it diagnosed by your doctor because many conditions produce runny nose symptoms accompanied with cough and itchy eyes.
Official safety records show that tachycardia or very fast heart beat is reported as a very rare side effect of the Loratidine. This means that in clinical trials less than 0.015% of the people within the trial suffered this side effect.
Other non drowsy antihistamines that can be used in a child of 32months include Cetirizine but this also lists tachycardia as a rare side effect.
This means that between 0.01-0.1% of the people in clinical trials suffered this side effect whilst taking this medication.
If your daughter has a previous history of heart beat problems or you are concerned for any other reason then you need to discuss this matter with your doctor.

Anonymous87 asked: Hello, My baby girl has a non-ige mediated milk allergy (suspected - negative on skin prick for soya and milk). I know the relationship between CMPA and the atopic march, but is there a relationship for CMPI/ non-mediated CMPA and atopic march? (ie: Do I need to fret as much about my girl developing asthma & eczema etc or is a non-ige allergy likely to be transient with no branching conditions)? Thank you so much, Fran.

Kamilla Dougherty our Health at Hand nurse answered: Many babies become allergic to milk before one month of age with most babies presenting within their first year of life. Studies show that about 2.5% of babies develop cow’s milk allergy at some point. The good news is that more than 80% of these babies will outgrow their allergy by 5 years of age. Babies who are born into families where the mother, father or a sibling suffers from food allergies, asthma, eczema or hay fever are more likely to develop cow’s milk allergies than those without a family history.

CMPA results from an immunological reaction to one or more milk proteins, with ingestion of CMP causing a wide spectrum of symptoms . If the reaction involves immunoglobulin-E (IgE) it is described as IgE-mediated, or classic food allergy, with symptoms generally occurring within minutes. Reactions involving the immune system but not IgE antibodies are described as non-IgE-mediated allergy5. These reactions are usually delayed (24-48
hours) typically affecting the skin or gastrointestinal tract.
Long-term prognosis: what is the likelihood of becoming tolerant to CMP?
The majority of children with early CMPA will eventually become tolerant to CMP. It is usually assumed that the child will become tolerant of CMP by the age of 5 years when their mucosal immune system matures and they become immunologically tolerant of milk proteins. In most children with non-IgE-associated CMPA, symptoms are likely to resolve by the time the child is 1 to 2 years of age. Children who are IgE-negative will become tolerant to CMP earlier and are at lower risk to develop other allergies.

Anonymous87 asked: My daughter is possibly growing out of her CMPA/ CMPI. At the moment, she is making masses of mucous and very very snotty with no other symptoms. Is this likely a response to dairy products or not? It's gone on for about 3 weeks now. No other known allergens and teething, which could be to blame. We've been told by allergist to persist with challenge in order to cure regardless - is this ok? Thanks ever so much.

Kamilla Dougherty our Health at Hand nurse answered: Depending on the age of your daughter production of a lot of mucus could be associated with active teething. Teething is a painful process and some babies react to it more severe then others, therefore produce excessive amounts of mucus or “drooling”.This can go on for the entire time of a babies teething time.

If teething and other allergies are ruled out and your allergy specialist is confident with the continuation of challenge then this is perhaps the way forward.